Sub-optimal positioning and attachment is the main cause of cracked nipples.

It makes sense to take steps to improve it.

When your baby has a deep attachment to your breast, it means your nipple is far back in her mouth, towards her soft palate, where it’s protected.

If the attachment is too shallow, it means your nipple can be jammed between your baby’s tongue and hard palate while she sucks. This can cause nipple damage.

When your baby is showing early hunger cues, use a breastfeeding position that works best for you and your baby. Hold your baby in close, so her chest is touching yours. Make sure you bring your baby to your breast, and not your breast to your baby.

When your baby’s head is tipped back and her mouth is open wide, bring her to your breast, aiming for your nipple to be pointing towards the roof of her mouth.

#3: Get Your Baby’s Oral Anatomy Checked

If you continue to feel nipple pain with breastfeeding, despite optimising positioning and attachment, it’s a good idea to get your baby’s oral anatomy checked out for a tongue tie or other concerns.

Good tongue movement is very important for breastfeeding. A good tongue movement helps your baby to attach deeply and remove milk well. If your baby has a tongue tie, it could result in shallower attachment, and/or not being able to remove milk well.

If milk is not removed well, feed after feed, it can result in a low milk supply.

#4: Speak With A Lactation Consultant About Topical Treatment Options

There are many different topical treatments mothers can use to help heal cracked nipples. A lactation consultant will help you work out what might work best for you.

There isn’t a great deal of Evidence to demonstrate the efficacy of most topical treatments. Whatever topical treatment you use (if you use one at all), once the cause is found and corrected, the nipple damage will heal.

The most commonly used products are purified lanolin or hydrogel pads. Both of these keep the nipples moist, which might promote quicker healing.

#5: Healing and Feeding Tips

If your nipples are cracked, here are some other tips that can help reduce the pain while you are breastfeeding:

Feed your baby when she is showing early feeding cues

With a clean finger, smear a few drops of your breastmilk, or apply a warm water compress, onto your nipples, to moisten them, just before attaching your baby

If you feel confident enough, change your breastfeeding position. This might help, by avoiding tension where the crack is

Recline back during feeds. This can help make the attachment deeper

Use nipple protectors to stop clothes rubbing your sore nipples

Change breast pads frequently

#6: Consider Expressing Or Use A Nipple Shield If Pain Is Severe

If the nipple pain is so bad that you can hardly bear your baby attaching again (at least for the time being), you might consider expressing or using a nipple shield. These methods will let you continue to provide breast milk to your baby, while reducing the pain and assisting the healing process.

If one nipple isn’t as bad as the other, consider direct breastfeeding from one side, while expressing or using a nipple shield on the other. Some mothers find even just 24-48 hours of expressing or using a nipple shield helpful.

#7: Be Aware Of Signs Or Symptoms Of A Nipple Infection

When a nipple is damaged, it increases the risk of nipple infection (e.g. thrush) or nipple vasospasm. Find out more about nipple thrush and vasospasm.

…

Nipple pain and damage can be awful. Be sure to get help quickly, so you can be on the road to having a comfortable breastfeeding relationship with your baby as soon as possible.

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Renee Kam IBCLCCONTRIBUTOR

Renee Kam is mother to Jessica and Lara, an International Board Certified Lactation Consultant (IBCLC), a physiotherapist, author of 'The Newborn Baby Manual' and an Australian Breastfeeding Association Counsellor. In her spare time, Renee enjoys spending time with family and friends, horse riding, running and reading.

Hello Renee, I am a newborn specialist and a graduate in the masters program in medical science with a concentration in newborn and infant development. I am very interested in becoming more trained in the area of lactation counselling. I have searched the web here in the US and can’t seem to find any directions in obtaining more training. We have LLL and IBCLC here but is it only for medically trained professionals? I am asking because I feel as though not much is advertised here in the US about breastfeeding and therefore not many training courses are available. If you know of any, please forward that information to me so I can help push the importance of breastfeeding in the US.

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